13-030 (8) 402 NORTH KING ST BP-2019-1147
GIS#: COMMONWEALTH OF MASSACHUSETTS
a 'Block: 13 -030 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
CatceorvDoor Replacement BUILDING PERMIT
Permit4 BP-2019-1147
Project# JS-2019-001657
Est.Cost:$8824.00
Fees40 00 PERMISSION IS HEREBY GRANTED TO:
Const Class Contractor: License:
Use GEMPELLA PRODUCTS, INC 096556
Lot Siae(sa. It.): 43560.00 Owner: ALLEN NANCY B&SARAH E SMITH
Zoning, Applicant. PELLA PRODUCTS INC
AT: 402 NORTH KING ST
Applicant Address: Phone: Insurance:
155 MAIN ST (413) 772-0153 Liability
GREENFIELDMA01301 ISSUED ON.•4/18/2019 0:00.00
TO PERFORM THE FOLLOWING WORK.-INSTALLING 3 DOORS USING EXISTING
OPENINGS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: y Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of OCCUDancy signature:
FeeTvpe: Date Paid: Amount:
Building 4/1820190:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
aov1�5
Cfly of No mpt6n
Building De riment
212 Main reed APR 1 6 201
Room 1 0
Northampton, A 01 onl
r - �FMIIMA
NSP
phone 413-587-1240 F :41 �«@F7po6 ln
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION �'��It 7� 7
1.1 Property Address-. This section to be c PWWI by office
402- N K1ng S� Map 0013 — Let- C 30
N04hami too qA 010(00 zon* Overlay District
Elm SL Dhnlct CB District
SECTION 2-PROPERTY OWNERSMPIAUTHORI2ED AGENT
2.1 7er of Record:
A3 Allen 402 N Ktro Nora mmplUn M4
—� M l iO�0101100Name(arra/ f - (n1Lbcll�+
2' Teleplg
$grebes
2.2 Autilorivid Aper:
—rrtnor PA 01;l`() )
Name( ' �, Clnenl MaSrg Ad ss:
41'x113 IISI
Signelurt TNepM
--TNMTEI)CONSTRUCTION C0978 I
Item Estimated Coat(Dollars)to be Official Use Only
winill6ted plinnitappricant
L Building 2�1 (a)Building Permit Fee
2. ElecNal _ �1 (b)Espmated Total Cost of
Construction from 6
3. Plumbing _ Building PermR Fee 1'
4. Mechanical(HVAC)
5. Fina Protection
6. Total=(1 +2-3-4+6) Check Number
This Section For Official ties Only
Building Permit Num Date
Issued'. /I,, I
Signature. l Ib" Z08
Building CommissiorenAmpedor M Buldkgs Dale
TbT' Oss @ cue lkcsdn . com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING al Information avat ae Completed.Perms Can M Denied Due To laomptete Infermation
Existing Proposed Required by Zoning
This column m Inc rIIM,n by
Hmldma Depesmmi
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(lel.minus Wit a paved
Piolow
#offrarking Spaces
I.velum.a Lpcaem
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW YES O
IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW IM YES O
IF YES: enter Book Page and/or Docum��l�rrrr(}ttten����t#
er
B. Does the site contain a brook, body of wator wetlands? NO O DONT KNOW 1` YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs Intended for the property? YES O NO (9j
IF YES, describe size, type and location: Y^
E. Vial the construction activity,disturb(casing grading,excavation,or filling)over 1 sure or is it pan of a common plan
Met Will disturb aver 1 acre? YES O NO
IF YES,than a Northampton Slam Water Management Permit from the DPW is required.
SECTION f~DESCRIPTION OF PROPOSED WORK(check all anollnble)
New Noose ❑ Addition ❑ Replauman ndawa A"On tion(si ❑ R.M.9 Q
Dr Doom
Accpsory Bldg. ❑ Demolition ❑ New Sgm IO] Decks 1M Siding=] 00,9,101
Brief Cis pdon of Zn
Work',Ti�=lltrh 3 fYOM mim exI%3nn4 �_wllh W CbMCM to hitildi�F
Alt nition of edsting bedroom_Yes 4L No Adding new bedroom Yes , >(1 No
Attached Nanativa Renovating unfinished basement _Yes _,6L_No
Plana Attached Roll -Sheet
9a.If Nsw hoes WA or*"Rim to""no houlna complete the 11011WAne.
a. Use of building One Family Two Family Other
b_ Number of roans in each family unit: Number of Bathrooms
e Is there a garage attached?
d Proposed Square footage of new construction- Dimensions
e. Number of stories?
I. Method of healing? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form aftsched?
h. Type of construction
i. Is construction within 100 ft. of wetlands?_Yes Ni Is concoction within 100 yr. floodplain_Yes_No
I. Depth of basement or cellar floor below finished grade
k. Will building conform W this Building and Zoning regulations? Yes_No.
I. Septic Tank_ City Sewer_ Pnvete well_ City water Supply
-SECTION 7a-OWNER A11Tf1ORWTWN--TO Be COMPLETED MEN
OWNERS AGENT OR COMRACTOR AAP/PIIES FOR BUILDING PERMIT
I. /V Q. /-T�.C.1 1 Ole/7 as Owner of this subject
property
hereD ay uthaizeyt\
to act on my behalf in as matters relative to wok authorized by this building parmit application.
O
Ci .Lc
�jof a�nYw ..a�� Date
as Owner/Authorized
Agent hereby declare Nal tiro atatemeas and inbrmabon on the foregoing application are true and accurate.to the best of my knowledge
and belref.
Sigud under the pain ono parishes of perjury.
PrintNe
slg
neW2 OwnclAgana Date
SECTION 8-CONSTRUCTION SERVICES
8.1 UparrM Conatnatt1w
SSupeMaor:Q M Not App{caabbis ❑
(Mm of uB.r..Hold, ll Cy�r Om1� s-0p&5ER
Litems Number
E 'p
( 1ipw
Addreu �Date
' 1
SIBelepher�e
,.�,,,�� � Not Applicable ❑
\ 1U til7J 7ET 1922-19
Comaarig Nam* Registration Number
1ntas Mcun G e FwJd MA 01301 1 31 nen
Address 1 Ekq tion ate
Telephane41301�%- 1151
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.ili§28g8))
Workers Compensation Insurenue elfidavK must be completed and submiffed with this applirabon-Failure to provide this alfidavd will result
in the denial of the issuance of the building permit.
S ned Affidavit Attached Yes....... No...... ❑
PELLA PRODUCTS INC.
155 MAIN STREET
GREENFIELD, MA. 01301
Date:
To: l/�_1�11 01F NSI l"1 Y1
Subject: Disposal of Debris
The purpose of this letter is to certify that all debris from any project
undertaken by Pella Products, Inc. in your town will be transported to
a dumpster at our main facility; 155 Main Street Greenfield, MA.
Pella Products, Inc. is under contract with Waste Management of Massachusetts
For the disposal of the contents of this dumpster.
Very truly yours,
PELLA PRODUCTS, INC
John P. Benjamin
Accounting Manager
The Common wealth ofMassackaasetts
FsEiiiiREEI Depatrinent of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
waiw.mass.gov/dla
Warkers' Compnuatiou Insurance Affidavit: Builders/ContraNma/Electriciane/Plumhen
Aildolkilat Information Plem Point MdW
Name(Budnesvag,ni>saawnai.iauu): C rcpt ✓I .�.
Address: /�S /%.•!.o
Ci lstatelzi ' ! A 013,21 Phone#: 3
Arc a u employer?Check the app prtata :: Type of project(required):
I. I un 8 employer with 'S <. 1 aril a general contractor and i
P Ycr _ 6. ❑New construction
employem(full and/orpart-time).• ave hued the wfreonMctors
2.❑ 1 am a wk proprietor or partner- listed on the attached shat. 7. WRognodeling
ship and have no employees These wbcomaaas have 8. Demolition
working for me in any capacity. employees and have workers' 9. ❑Building addition
[No workers'comp. insurance comp.insurance.:
mqdured) 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ 1 am a hanaousu r doing all work officers have exercised their I I.❑Plumbing repairs or additions
myself[No workers'comp. right of exemption per MGL 12.❑ Roof repairs
insurance inquired.]• c. 152,§I(a),and we have no
employees.[No workers 13.0 Other
comp. insaarcerequired.)
•AnY
nations
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mnalo)em. Iran nrmmaaon hive mNayeW.Nei inn Pnvitla Ned.atm:wow pdkY awrer
/esu an mpiryn uratr proa4ing wonten'eorpeartlomr brarranee jar req enp/ayea. ffdaw h ahr poaryend/ob ske
htferarfbn.
lrma.n«canp.ny N.mr:_ /�nnl/�trim. �'xrtlF lJ ecu/✓
Policy a or Self-ins.Lic.0: L!�/J/fN ./� 7 6SOrx Expiration Date: D/" O(' � (J
Oof
lob Sita Addrms:�n2 N 1'l1co City/statelzip:No r*nnh MA QIP
Attach a copy of the workers'compeaatia policy dahratioe pad(showing the policy number dad expiration date).
Faille m secure coverage as required under Section 25A of MGL c. 152 can lad to the imposition of criminal paallies of a
few my to 81,500.00 and/or orw-year imprisonment,as well as civil penalties,in the form of a STIP WORK ORDER and a fine
of up to 8250.00 a day against the vielaor. Be advised that a copy of this stafmme nt may be forwarded to the Office of
Iovealigaias of the DIA for uunanrx coverage verification.
I do hereby cargo anal she pelm andpombliff tion the hrJbraratlen Provided shone it orae ad/casrers.
cimamw.. a t���
Data,
ta,wmw a
OQ9eb/we only. Do see wrkr in this area,m be complard by cky or town ajjlcial
City or Tows: PermtULieeoae a
ttaafq Authority(drele ode):
1.Bard of Health 2. Beildlag Department 3.Cityrrguwv Clerk d. Electrical inspeemr c. Ptambing Imapeetor
6.Other
Contact Person: pbae A:
wcd CERTIFICATE OF UABIUTY INSURANCEYP1,D Dlq
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CERTIFICATEDOESMDTAFFBOM N YORMEQAT YAMED,E)DEO QA ALTEi TIE COVERAGE AFFORDED BY THE POLICES
ND.OW. THIS CER11F1f M DF NEIIRANCE DOER NOT CONBTNTDTE A CONTMM BETWEEN THE UWJWM PURMUBA AUTHOM ID
REPRESENTATIVE OR PRODUCER.AND TIE CERTMOTE HOLDER.
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0 1M 5 ACORD CORPORATIM AE rWft N•NYe6
ADDRD W(3016D]I TW ACORO was•nN YSO NB NSYYIM mub a ACORD
Pella Products, Inc.
155 Main Street
Greenfield, MA 01301
Office:413-773-1157 Ext.317 Cell:413-834-8799
To:Building inspector
From:Trevor Bross—Installation Manager
Date: March 5, 2018
Subject: Building Permit Applications&Designees
Pella Products Incorporated is in the business of replacing windows and doors for our customers. Our process includes
providing a building permit for each and every project.
I am a licensed Construction Supervisor. Building Permits will be applied for using my CSL#CS-096558 and my
HIC#142279. Please find a copy of my licenses below.
Cameoel esM.W YueslweNis Conetrutlios SupenMrc
OMYee* It41PYywe Rc.IrKe4 to
bW if MrMYb Umestrwwe euMiryear uM yaq 001901 eerIY111
Ia than 35.000 cube fM
IL ox
mdav Gr
eWYsed space_
onw gWE NAMO eeYYYW O
TPE;supeM CaM
11 RpYbYbn
wMbrMNYurtwpst,
W4 URI[IMB
O acY �Yia d.YY.Rea�+Yn
PEVA PRODUCTS;MID.
TREVORBROSS
155MAINSTREET
GREENFIELD.MA 01301 Un wwroYry
Each Installation will be staffed by our installers who are all licensed in accordance with current building codes. Below
listed are our installers and their license numbers. Please accept these individuals as my designees.
Willard Brown CS106010 Vladimir Shevchuk CSSLO99209
Scott Bowdish CSSLI00232 Bill Leger CS89338
David Ruffner CS57308 Brian Thompson CS67121
Igor Kravchuk CS094911
Contract - Detailed
Pella Window and Door Showroom of West Springfield gales Rap Name: Schulz,Jonathan
e 69 Ashley Avenue gabs Rep Phone: 413-736-9239
West Springfield, MA 01069 Sales Rep Fax: 413-736-3390
Phone: (413)736.9239 Fax: (413) 736-3390 gabs Rep E-Mail: jschulzQpeIIasales.wm
/Ids Order IR10rmadiM1
Mom Allen Allen Morey 402 N M0n9 St Northampton MA 01050 Quote Noe: Allen Nancy 225&809 Entry Ski&Patio Doors
402 N King St 402 N King SI
Order Number: 739T2ES031
NORTHAMPTON, MA01060-1121 Lott Oude Number: 11226852
Primary Phone:(413)6871093 Northampton,MA 01060-1121 Order Type: Installed Sales
Mobile Phone: County: Payment Tame: C.O.D.
Fax Number Tax Code: MASS
&600: IecMang99@nen mm Quoted Date: 452019 5122
Gnat PMM 0: 1005145347
Cuatarrwr Number: 1009097848 OV r A&AI n " 1�*,L-f$�-
CuManw Aceoun: 1005145347
Cusiomer Notal: House iwilt 1942. includes installation,buildrg permit,sales Mx,and deposal. Friermdy anirtals on lint.
Check received 04/092019-$4400.00. Remaindar$442400 upon completion.
Lead We Practices
For more information regarding the finishing, maintenence, service and warranty of all Pella®products,mstt the PelleS website at www.Pella.wan
Prinadon 4/102019 Correct-Detailed Page 1 of 12
Customer. Nancy Allen Project Nmne. Alien Nancy 402 N King St Nortllmrpton MA 01060 Order Numha. 739TZES031 quote rl miter. 11226652
laaaaan,
10 Raw 0oor Pella Brand,Entry Door Inswing,31.5X 78.75,Poplar White, 59116" loam Price City Exr'd Prim
1 $3.97239 1 $3,97230
/ 1:3080 Entry Door
■ PKI Frans Size: 31 la X78314
2D33 Unit Type: Left Inswing.Standard SAI No Fire Rating,No Fire Rating
Dlrrrawnn Options: CW Down T7own"lnformaeon: S7/6. 15116',5 SiMv✓
i Paw": 12 Light✓
Glass: Tempered!lmv-E Fir FAted
Vowed From Exterior Groin: No Gnlle
Paw BtlMlon: Smooth,Panted.B.*Ped,Palntad.eawraaC LINW NAyflF-
Frans Selection: Clad, Pine,Oak 7hreahold. No Parity Reedomamere.Standard E ldrawcod. Popkr Nuts,Wood, Linen VftM
Hardware options: Latch Bora with Creditor,2316,21 Ar No Integrated Sensor,No Nandur Sat Standard Stool,Breadoro�jnc Dichranae,&sae
Pna,5II
Unit Aonsso les: No Beg Panel
Pwforrrrarlu mlonrwion: l Fedor 022,SHOC 009,VLT0.15,CPD EL-M-170.02400.00001,Csk:Waled Posove DP Rating 30,Cssc awl Negative
DP Rating 30,Year Rated 08
Wrapping Inlortrralon: Nail Fin,Factory Applied,No Exterior Tr 5911 7/6°.Factory Applied,Peua Recommended Clearance, Perimeter Length=
Frame Slae:31.5'X78.75' 1 fAd If7>i�S
ED-1 -Envy Dov Inswadan W10 Saalght Ory 1 , C � 7�/H %
Eli-EXT Alarinur Mcltneuld Capping Ory i l�
LP.1 -Lead saes practices Uis opening Ory 1
WCa1l0a_ Agnail$BS
15 interior CNN Wood Products 3112 CreBsmen 2,Length:96, Linen White.Wood Type: Pine Hawn Prim City Exrd Prem
579.62 3 $14888
1: Accessory
PKI Fran,Sae: 1 X 1
2033 General mremasun: Pins.31/2 Craftsmen 2
Inkedor Colorl Flnlal: Limn Whaa Paintlrawior
Wrapping hllorrtralon: Perimeter Length=Q.
Vexed From Exei
Frame Slee:0'X 0'
For more information regarding the finishing, maintenance,service and warranty or all Pella40 Products,nor¢the Palla®welosee at www.Pena.com
Pnnadon 411"19 Contract-Detailed Page 2 of 12
Cusco na:Nancy Allen Project Name: Allen Nancy 402 N King St Natlbnplon MA 01060 Order Number 73MES031 Ovule Number: 11226652
tap�kn: Andbdo
20 Transition slip Wood Products Stool Round 2,Length:96,Natural Stain.Wood Type: Oak hem Price City Exna Prim
$706.06 1 SI06.04
1: Accessory
PKIF Frasla Slate: 1 X 1
2033 General Inlornr/on: Oak.Stool Routs 2
Interim Color 1 FMIM: Natural Stein Irasrar
Wrapping Inbmatlon: Perimeter lenllth=G'
Viewed Fran ExMa
Frame size:0'X 0'
t.orm:
25 Roar Swm Entry Systems, Stam Door Nfidlriew Rolscreen Right, 30 X76,Poplar Wirke item Price City EKt'd Paid
a 7-' 51.262.92 1 $1.262.92
6•,• 1:Nom&ndamd SluNonStnaN She Rlghl erorm Door
PKF Frame Slate: 30x76
20M Gwwrel lnfam agm: Gaal
Ealxbr Colorl Rnlsh: Shuslard EMursdad,Papal White
Sash 1 Panty: 1'Said Core
Glass: Clear
Gdltes: No Gelb
Viewed Fran Exlena Hardware Corinne: Standard,Ennis Exterar I Coke Malchsd Interior
Me": 3525
Wrapping IMomrtlan: Perimeter Lerpth=216'.
Froser Size:30'X 76'
E041-Ssorm Door Insall on PalN Entry Door Ory 1
For more information regarding the finishing, maintenance, service and warranty of all Pella®products,wait the Pella®wensite at vmw palls.corn
Rindon 4IM19 ContactDetailedPage 3 of 12
Custdrer: Nancy Allen Projerl Name: Allen Nancy402 N King St Natlwrplon MA 01060 Order Number. 739T2E5031 Quota NurlBer. 11226652
W"— Laclaw AiM101MS.
� a Pelle 350 Series, Double Sliding Door Fixed I Vent Lot 71.5 X 79.5,Almond Bent Price City Ext'd Price
S4,748891 u roe ee
1:72ea Find I Vat LM DouWla Seeing Door,
:.� FXs Frame e4s: 7112X7912
c pts (?oral IrdomYYM: Yea,Slvdard.N-50.N-50,Vinyl.Nail fin, Foam raListed.6'. 1 3re'.4 59',IJo SA Row
I Exhis or Calor 1 Finish: Almond
GlInsides:'Colordid Fresh; AJ,nTempered
y}�O�
filen: Ise dal Tempered Lox-E mnd,Al ond. teal irM Glee/ r W Non High Pllihde
Natuna: Opng So Keylocwn.Nkinducted Cor Almond.Steal
VAWBd Fmm ExWdv paned: sore Screen.oceu Premium,Converlional Fibarplaes
One Accessories: Noion: L-Fa Option
Ruling
5 .Col dated ogle l DP R 0.33, .Yew Rate VLT 0.51.GPD PEL-N-161 0110PQ00)1,Perlormarce Clave R,PG 50,Calculated PoaNve DP
Reline 50,CekWeled Negetiva DP Retire 50.Vear Rated O8111
Califs: No Gr .
W rappingillo
Inlomalbn: PNIa Recommended Clearance.Perimeter lerpth•302'.
Frame SW:71.5'X795'
PD4 -Page,Doan Install up to SFT In width Ory 1
LP-1 -Lase sift practices,this opanit g Ory 1
FAC43M-EXT AluMnum BdekmouW Capping Qty t
1J4w1Y11:
35 mrkrCall Wood Products 3112 Craftsman 2, Length:96, Lints White.Wood Type: Pine them Price Oty Exrd Price
54982 3 $146.86
(� 1: Accessory
Li.J 2D3 Flowsgeneral
Bina: 1 %1
�p General Inbmainis Pine,3la WhQA4man2
WeederInlor oslsh: Linan Wtile Pain)lraedor
Wrapping IMemalbn: Perimeter Length=T.
Vsaed From Eebda
Frame She:0'X T
For mon information regarding the finishing, rnwMenonoe, service and warranty of all Poling products.Nwt the Pella®website at www polls mm
Pdnbdon 4192019 Contract-Detailed Page 4 at 12
Custara.Nervy Allen Project Nana. Allen Nancy 402 N I(ug St Nattla#m MA 01080 Order Number 73gT2ES031 Quote Nurnow 11226652
Q�rgect Checklist has been rovievied
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Cuabmer Name IP'ea+e rTul Pelle Sable Rap Name 1 ++ee'�annj Subtotal $5,067.21, x a 6.25% 5318.71able Subtotal 53,440.88,824.Dam Dale Received 54,4,00.Due $4,42COI
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